| NPI | 1164506895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OR MD16285) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OR 16285) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD00027143) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2015-04-28 |